Charity Fundraiser Publicity Consent Form
Please complete this form to provide consent for the use of your name, image, video, and testimonial in charity fundraiser publicity materials.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the Fundraiser
*
Please Select
Donor
Volunteer
Sponsor
Beneficiary
Event Attendee
Other
Fundraiser Event Name
*
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload Your Photo or Video (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Share Your Testimonial (optional)
Signature
*
Submit Consent
Submit Consent
Should be Empty: